Treatment of Severe Atrophic Maxilla With Zygomatic Implants: A Case Series

Abstract

SUMMARYTreatment of severe maxillary atrophy with implants has achieved important successes in recent years. The limit of implant insertion is related to inadequate bone quantity (i.e. height and width). Alveolar bone grafting, sinus lifting and major grafting via Le Fort I osteotomy have used in the past to restore bone volume prior of implant insertion. However successes do not always occur and a second stage surgery is necessary in most cases. Immediate loading cannot be performed in all grafted bone. In recent years a new treatment approach has been proposed by using zygomatic implants. This new technique can provide a better stability to the prosthesis and less morbidity for patient. Here a cases series of eighteen patients rehabilitated with zygomatic together with standard implants and immediate loading is reported.

Alternativa para el tratamiento de la atrofia severa de maxilar superior: casos clínicos de implantes cigomáticos

“…El procedimiento convencional, definido por Branemark en 1998, consistió en la colocación de un implante de 35-55 mm de longitud anclado en el hueso malar siguiendo una trayectoria intra-sinusal. Desde esta descripción, muchos autores han variado ligeramente la técnica: siguiendo el contorno del hueso malar evitando de fenestración del seno maxilar, colocándolo a vestibular del seno maxilar; combinado con implantes anteriores; reduciendo los tiempos de carga; o modificando la carga protética 8,[14][15][16] . Una revisión sistemática de carga inmediata de estos implantes, concluye que es una técnica recomendable ferulizando ambos implantes 17 ; aunque técnicamente es más complejo.…”

Survival Rate of Zygomatic Implants for Fixed Oral Maxillary Rehabilitations: A Systematic Review and Meta-Analysis Comparing Outcomes between Zygomatic and Regular Implants

“…According to local anatomy and sinus cavity dimensions, many different approaches have been proposed for maxillary rehabilitations with 4/6 tilted dental implants [ 12 , 13 , 14 , 15 ] in combination with single/bilateral zygomatic implants. These severe cases are often correlated in clinical practice after severe bone resorption, local infections and resective oncologic surgery [ 16 , 17 ]. Zygomatic implants have been proposed as a valuable treatment option for fixed rehabilitation in severe reabsorbed bone ridges due to the reduced invasivity, morbidity and decreased time required to finalize the rehabilitation [ 5 , 17 , 18 ].…”

“…These severe cases are often correlated in clinical practice after severe bone resorption, local infections and resective oncologic surgery [ 16 , 17 ]. Zygomatic implants have been proposed as a valuable treatment option for fixed rehabilitation in severe reabsorbed bone ridges due to the reduced invasivity, morbidity and decreased time required to finalize the rehabilitation [ 5 , 17 , 18 ]. Zygomatic implant positioning is an approach that avoids grafting or maxillary sinus augmentation and consequently produces a shorter and more comfortable post-operative morbidity [ 18 , 19 , 20 ].…”

“…Other indications for zygomatic implants include the previous failure of conventional implant placement, failure of grafting procedures and tumor resection or trauma [ 4 , 12 , 17 , 24 ].…”

El tratamiento con implantes cigomáticos en pacientes con atrofia maxilar severa

“…El tratamiento del paciente con implantes cigo-máticos requiere un plan de tratamiento complejo que incluye el diagnóstico clínico y radiológico tomográfico computarizado, un estricto protocolo quirúrgico, una adecuada rehabilitación prostodóncica y para conseguir el éxito a largo plazo un programa de mantenimiento y revisiones periódicas [9][10][11] .…”